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Vaginismus therapy and countermeasures
The vaginal cramp (vaginismus) is an extremely uncomfortable and painful complication in the context of sexual intercourse. Women who chronically suffer from it can hardly enjoy intimacy, which makes intimate togetherness a real problem. But there are ways out of vaginal cramping.
A vaginal spasm is a sexual dysfunction that causes spontaneous cramps in the vaginal muscles. Strictly speaking, it is the outer third of these muscles that line the female vaginal entrance. In addition, the pelvic floor muscles are also affected by the spasm.
As with any form of convulsions, appropriate signal transmission of nerve impulses to the affected muscles is also responsible for the problem in vaginal spasms. To date, however, the exact origin of vaginismus has not yet been fully clarified, although both physical and psychological causes seem to be considered. In this context, two main forms of vaginismus are distinguished:
- Primary vaginismus - the vaginal spasm already existed at the time of the first sexual intercourse. Here, physical causes are mostly responsible for the cramping process during the act.
- Secondary vaginismus - vaginal spasm only appeared after a certain event. In addition to physical causes such as a vaginal birth trauma, secondary vaginism often also shows psychological causes, such as those associated with trauma after rape.
useful information: A vaginal cramp can not only occur during sexual intercourse, but basically with every attempt to insert a foreign body into the vagina. In addition to acts of masturbation, this also includes gynecological examinations using a speculum.
Physical causes of vaginal cramp
Physical causes represent the less common proportion of factors that cause vaginal cramps. They can occur early in the development of the female body. For example, if the hymen of a girl is very narrow and therefore difficult to penetrate, this sometimes leads to cramping reactions during penetration. This applies both to the first sexual experiences of the young patients, as well as to gynecological initial examinations and the use of tampons.
Now, older women also complain of vaginal cramps. The cause here can be the hormonal change during the menopause. The changed hormone activity rarely leaves a trace on women and affects not only the psyche and metabolism, but also muscle and nerve function. In addition, an age-related lowering of the abdominal organs due to a weak pelvic floor is conceivable as the cause.
In addition to these natural physical factors, infections in the genital area and in the urinary tract are also able to cause vaginal cramping. These include in particular urinary tract infections such as cystitis and venereal diseases such as chlamydia. The physical causes of vaginismus also include birth injuries at the entrance to the vagina, vaginal tumors and adhesions in the area of the vagina, for example as a result of a surgical intervention.
Last but not least, physical vaginal cramps can even be attributed to medication and hormone-based contraceptives, since their side effects are quite possible. Of particular note here are hormone-based contraceptives such as the pill and medicines for the treatment of urinary incontinence.
Psychological causes of vaginal cramp
Vaginal cramps caused by psychological factors are far more common and can be rated as much more critical. Vaginismus due to short-term stress or unsubstantiated fear of sexual intercourse would be relatively harmless. Often, however, several factors come together, which patients initially do not perceive as a triggering factor, but their severity should not be underestimated.
For example, the causes of psychologically motivated vaginal cramps can often be found in traumatic experiences from the past. These can also have been made by the woman very early in the development, without her being able to remember it in detail. The main reasons for this are clearly the strict upbringing of girls, in which female sexuality was always treated negatively and the exploration of one's own body was a taboo. The result is sexual inhibition, which is particularly evident in intimate contact with the opposite sex. Experiences of abuse or similar trauma, such as sexual harassment as the cause of psychologically induced vaginal cramps, are of course even more traumatic. In addition to childhood, these can also lead to secondary vaginismus in every other phase of the woman's life.
However, it should now be mentioned that the unpleasant physical experiences that are the basis of the secondary vaginal spasm do not necessarily have to do with cases of abuse or sexual inhibition. Severe diseases in the lower abdomen or a traumatic birth can also subsequently provoke cramping in the vagina due to the situation-related pain experience. Likewise, conflicts in partnership or unconscious fears, for example before a potential pregnancy, can emerge as causative factors. The situation is similar with a disturbed self-awareness and low self-esteem. For example, if there are unprocessed inferiority complexes or a pronounced sense of shame, the woman can develop vaginal cramps. In this regard, it is again worth pointing out a corresponding upbringing in childhood, but also social pressure, bullying and exclusion.
Symptoms of vaginal spasm
Cardinal symptoms in vaginismus are cramp-like pain and a reflex-like narrowing of the vagina when trying to insert a penis or other objects into the vagina. It should be mentioned that the sexual partner can also feel extreme pain on his limb if it is in the vagina at the time of the narrowing. The physical complaints are not the only symptoms in the course of this sexual dysfunction.
As shown, the causes of vaginal cramps can be very diverse, and the whole thing is often based on a multifactorial process. As a result, affected women develop a high level of suffering, which, in addition to the painful convulsions, is exacerbated by the fact that sexual problems of women are still often regarded as a taboo subject by society. Often, patients do not trust a gynecologist to have the problem clarified by a doctor, and there is no relief in therapeutic discussions. This psychological stress, which is characterized by shame and fear, often results in an extremely tense fear of intimacy, which increases the likelihood of a vaginal cramp.
The easiest way to determine a vaginal cramp is, of course, an open discussion with a treating gynecologist. At this point women who are ashamed of their convulsions are clearly encouraged to talk about their problem! Because psychological causes for the illness can be revealed almost exclusively within a detailed medical history. The further gynecological examination can then possibly trigger the vaginosis through acute vaginal reactions to inserted examination instruments, which gives the doctor a first picture of the physical sensibilities. If there are no corresponding reactions, the eye diagnosis can at least help to find physical causes such as scarring, inflammation and infections. Depending on the individual situation, further diagnostic measures may consist of blood tests and smears to reveal pathogens and signs of inflammation.
Therapy for vaginal cramp
Therapy for vaginal cramps is always dependent on the triggering factors. Important prerequisites, and preceded by all further steps, are of course breaking the silence and an offensive and goal-oriented handling of the woman concerned with her sexual disorder. Because nothing else is the vaginal cramp. It is not a taboo topic and nothing to be ashamed of, but simply a sexual dysfunction that can and must be treated in the same way as any other disease. Once patients have realized this, there are numerous treatment methods available to remedy the problem.
Organic or physical causes can often be eliminated very quickly. For example, through antibiotic treatment for infections, the professional cure of birth injuries by means of wound care or a change of preparation, if drug side effects cause the problem.
On the other hand, it is not advisable to use standard medicinal treatment for psychological causes as a trigger for vaginal cramps. If the vaginal spasm problem is based on a serious mental disorder, such as manifest depression or an anxiety disorder, antidepressants and other psychotropic drugs can help, but in the case of profound trauma, talk therapy has priority.
Caution: There are instructions for use that recommend local treatment with anesthetic ointments before sexual intercourse. Again, this is not advisable without clear consultation with the doctor, since numerous active ingredients contained in these ointments can additionally worsen the functional disorder.
The first step in treating psychological causes as triggers for vaginal cramps is to perceive and recognize the disorder and to act accordingly according to medical instructions. In gentle conversation therapies, affected women (if desired also with the involvement of their partner) can discuss the possible causes together with the therapist and discuss suitable treatment steps. Depending on the causal factors, various options are possible, including:
- Cognitive behavioral therapy,
- Talk therapy,
- learning relaxation methods,
- Trauma therapy,
- and couple therapy.
Home remedies and relaxation measures
In the home environment, patients have the opportunity to do a lot themselves to alleviate the problem and tackle their vaginal cramps aggressively. The first priority here is of course the open and trusting conversation with the partner. The joint decision to tackle the sexual difficulties as well as the support of the partner can already take some tension off women. The joint planning of private measures to remedy the malfunctions then contributes to the rest. It is important that both partners can address their wishes and needs openly and that preferences and dislikes are discussed in depth. Such information should also be expressed during sexual intercourse.
For example, common, warm baths in preparation for the act can contribute to relaxation in this area. Other rituals can be found in listening to relaxing music or enjoying a romantic film for two with a glass of red wine or an aromatic cup of tea in a relaxed atmosphere.
In everyday life, common companies are just as important as fixed points of retreat for each partner in the event of stress in order to avoid tense situations. Detached from the partnership, patients can also do their bit to solve sexual dysfunction in everyday life. This includes learning relaxation techniques such as yoga or meditation, getting to know and accepting your own female anatomy after prior guidance from a therapist and that
Performing pelvic floor training (e.g. with the help of vaginal dilators) according to instructions.
Warm hip baths are recommended in medicine to relax the pelvic floor muscles. They are particularly effective with anticonvulsant additives such as hay flowers.
Abdominal tumors, adhesions or injuries that do not function properly can and should be surgically removed or corrected for vaginal cramps. Lowering of internal organs, a pelvic floor weakness or certain forms of urinary incontinence can also be remedied using surgical - sometimes even minimally invasive - methods.
Diseases of vaginal spasm
Vaginal narrowing, vaginal adhesions and wounds, vaginal infections, urinary tract infections, venereal diseases, trauma, stress, sexual inhibition. (Ma)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
- Daňková Kučerová, J. et al .: Vaginismus - who takes interest in it ?, ceska gynekologie, (accessed August 27, 2019), PubMed
- Rosemary Basson: Vaginismus, MSD Manual, (accessed August 27, 2019), MSD
- Rosemary Basson: Overview of sexual functions and sexual disorders of women, MSD Manual, (accessed August 27, 2019), MSD
- Peer Briken, Michael Berner: Practice book sexual disorders, Thieme Verlag, 2013
ICD codes for this disease: F52.5, N94.2ICD codes are internationally valid encodings for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.